Overview of CCPA's managed care plans
CCPA pursues payor contracting on behalf of its members through a "messenger model" which is compliant with federal and state antitrust laws. As the area's only pediatric IPA, CCPA has fee-for-service managed care contracts for pediatricians and pediatric specialists.
CCPA currently offers participation in sixteen managed care contracts to all of our members. In addition to providing assurance to our practices that CCPA's contracts offer adequate reimbursement rates for vaccinations, nebulizers, and preventive and newborn care, CCPA managed care offers the following benefits to our members:
Flexibility
Although CCPA encourages participation in all of our plans, members decide for themselves which plans they would like to participate in and have the flexibility to opt in and out of any of CCPA’s plans at any time.
If you are a member of CCPA and would like to update your managed care participation, please visit our managed care contracts page (requires member login). Or call Kathleen Heaton at 773.975.8747.
Delegated credentialing and recredentialing:
Because CCPA obtains approval to perform the credentialing functions from our contracted managed care companies, members can complete only one application and submit it to one organization, CCPA.
To access the State of Illinois credentialing or recredentialing applications, please visit the Illinois Department of Health (IDPH) Web site at: www.idph.state.il.us/about/credentialing.htm.
Current CCPA members: review the recredentialing schedule for physicians to see when you will be recredentialed next with CCPA.
Communication with managed care companies on your behalf
CCPA will assist you by informing managed care plans when your personal or practice information such as your last name, practice name, practice address, etc. has changed. We will also follow up with the plans to ensure that the update has been made in their systems. Please click here for a guide of what to submit to CCPA when an update has been made to your personal or practice information: Submit updated personal or practice information to CCPA (password protected). Once you submit the appropriate paperwork to CCPA, we will send notice to the managed care plans that you participate in through our contracts and forward to them the necessary paperwork.
Support staff
CCPA has a knowledgeable staff to assist your practice with managed care issues. If your practice experiences difficulties with any of our managed care plans in verifying participation in plans, receiving correct reimbursement rates, updating physician and practice information, or any other issue, please contact a member of the CCPA staff at any time for assistance.